Documente Academic
Documente Profesional
Documente Cultură
Health Ethics
and Law
For Health Extension Workers
Challi Jira
Jimma University
In collaboration with the Ethiopia Public Health Training Initiative, The Carter Center,
the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education
November 2004
Funded under USAID Cooperative Agreement No. 663-A-00-00-0358-00.
Produced in collaboration with the Ethiopia Public Health Training Initiative, The Carter
Center, the Ethiopia Ministry of Health, and the Ethiopia Ministry of Education.
All rights reserved. Except as expressly provided above, no part of this publication may
be reproduced or transmitted in any form or by any means, electronic or mechanical,
including photocopying, recording, or by any information storage and retrieval system,
without written permission of the author or authors.
This material is intended for educational use only by practicing health care workers or
students and faculty in a health care field.
Acknowledgments
Recognizing the importance of and the need for the preparation of the
lecture note for the Training of Health Extension workers THE
CARTER CENTER (TCC) ETHIOPIA PUBLIC HEALTH TRAINING
INITIATIVE (EPHTI) facilitated the task for Jimma University to write
the lecture note in consultation with the Health Extension
Coordinating Office of the Federal Ministry of Health.
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Table of Contents
Topics Pages
Acknowledgement ..........................................................................i
Table of contents ........................................................................... ii
Introduction ............................................................................... 1
Bibliography ..............................................................................42
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Introduction
The preparation of this lecture note on health Ethics and health laws
is important and timely as there is no appropriate book to address the
subject in teaching health Extension Package Workers.
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UNIT ONE
Background and Rationale
1.1 Background
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Policy on Health
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The code of ethics for public health will clarify the distinctive
elements of public health and the ethical principles that follow
from or respond to those distinct aspects. The Health Extension
workers will be abided by code of ethics of public health in
rendering public health services.
The concerns of public health are not fully consonant with those of
medicine, however, thus we can not simply translate the principles
of medical ethics to public health. For example, in contrast to
medicine, public health is concerned more with populations than
individuals, and more with prevention than with cure.
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UNIT TWO
Health Ethics
Learning objectives.
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The word ethics is derived from the Greek ethos, which means
custom or culture, a manner of acting or constant mode of behaviour.
Thus, Health ethics may be defined as a code of behaviour
accepted voluntarily, within the profession as, opposed to laws,
regulations and directives issued by official body or scientific
study of morality. It teaches us how to judge accurately the moral
goodness or badness of human action.
Morality
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Importance of Ethics
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Justice (fairness)
This principle states that human being should treat other human
being fairly and justly in distribution goodness and badness among
them. In other words justice should include:
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UNIT THREE
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Section 14: Health Extension Worker should carry out the best
interest of the clients.
Section 15: HEW experience, judgment and practice must not be
affected by economic interest in, commitment to, or
benefit from health related commercial enterprises.
Section 16: Communications to colleagues must be accurate and
truthful.
Section 17: Communications to the community must be accurate.
She/He must not convey false, untrue, deceptive, or
misleading information through statements,
testimonials, photographs, graphics, or other means.
They must not omit material information, without which
the communication would be deceptive.
Communications must not appeal primarily to an
individual’s anxiety or create unjustified expectations of
results. Communications must not misrepresent the
Health Extension worker credentials, training,
experience, or ability and must not contain material
claims of superiority that cannot be substantiated.
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UNIT FOUR
Existing Health Laws In Ethiopia
Learning objectives
At the end of the unit the trainees will be able to:
• Understand existing health laws in Ethiopia
• Interpret and implement health laws in Ethiopia
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Summary of Legislation:-
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See Appendix I.
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Analysis of Legislation
2/31 (1943) L. 25: Sanitation Rules
The major function of this legislation is to empower the HEW to issue
order regarding various health matter the legal Notice is Primarily
concerned with; (1) wells; (2) seizure of foodstuffs; (3) disinfestation
and vaccination, and (4) disposal of refuse.
In order to enforce all rules and regulations in these areas the second
section of the legal Notice authorized HEW on the matters with which
these rules and concerned and covered by later laws, which probably
would be more suitable for prosecution. The one rule which does not
appear to be covered by the later is that which permits the (HEW) to
require dangerous wells to be closed. The law is directed toward the
public enforcement authority rather than the individual. The law does
not seem to hold the individual responsible but merely requires the
public enforcement authority to take remedial action. Therefore, there
is some doubt about the validity of enforcement of this law in local
communities.
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The legislation prohibits: (1) offering unsafe water to the public for
drinking: (2) urination or defecation in public places or places other
than a properly constructed fly-proof latrine; (3) exposing human
excrement to flies or rat of permitting such to be exposed upon his
premises; (4) the exposure and discharge of sewage into water
courses without a permit; and (5) the discharge of sewage into
cesspool or abandoned well more than ten meters deep, or
contamination of the natural ground water at a depth greater than ten
meters.
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The Food Laws: (1) prohibit offering to the public food unsafe or
unfit for human consumption (2) food contaminated with human waste
material as dangerous to public health; (3) define certain foods as
unsafe for human consumption: (a) meat without stamp of public
municipal slaughter house; (b) milk from animals having tuberculosis
infections, abortion, or anthrax cases; (c) other food declared unsafe
by the HEW; and (d) vegetables irrigated with water containing
human excrement; (4) authorize the Woreda Health Office to sample
the foods; (5) prohibit the serving of food or drink in containers or
with utensils not properly washed and define washing standards; (6)
prohibited food or drink containers from being used which are not
capable of being cleaned; (7) require all places where food or drink
is served to prevent the access of flies, roaches and rats to the food;
(9) require that butcher shops to be thoroughly cleaned daily; and
(10) authorize the HEW to grade restaurants and other shops selling
food to the public according to standards she has drawn up and to
issue a certificate stating the grade that the shop has been given.
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Articles 503-520
These Articles are primarily concerned with offences against public
health. This section of the code, comprising Title VIII, is concerned
with promulgating specific laws which prohibit certain offences
against the health of the community. Listed as “Infringement of the
general protective provisions” are the following laws:
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warrant. This article prohibit the police from arresting any individual
without a warrant unless the person arrested is reasonably suspected
of having committed an offence punishable with imprisonment for not
less than one year. This article in effect precludes almost all public
health legislation in Ethiopia. Therefore, the HEW should be aware of
bringing individuals into the court before securing a warrant from the
proper authorities.
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Bibliography
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17. Challi Jira (2002). Health Ethics and legal medicine for Health
Oficer students, Lecture note series, Jimma University Faculty
of Public Health.
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APPENDIX I
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PART ONE
General
1. Short Title
2. Definitions
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5. "Health" means not only the absence of diseases but also the
complete physical, mental and social well being of an
individual;
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10. "Building" means any kind of structure with wall and roof
including any mobile structure made for shelter;
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PART TWO
Advisory Board
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PART THREE
Inspection
6. Appointment of Inspectors
The Public Health Authority shall appoint qualified and capable
inspectors to implement the provisions of this Proclamation and
other laws and directives related with public health.
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PARTFOUR
Public Health
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PART FIVE
Miscellaneous Provisions
19. Obligation to Cooperate
Any person shall have the obligation to cooperate for the
implementation of the provisions of this Proclamation.
20. Penalty
Unless the Penal Code provides a more severe penalty:
1) any person who violates Article 9 of this Proclamation shall
be punishable with fine from Birr 2500 upto 5000.
2) any person who disposes waste outside a garbage container
in a manner that can cause the contamination of the
environment or can create a health hazard, is punishable with
simple imprisonment from three months to three years and
with fine from Birr 1000 upto 9000.
3) any person who violates Article 11 Sub Articles (1) and (2) of
this Proclamation shall be punishable with fine from Birr 1000
up to 9000 and with simple imprisonment from one month to
one year.
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